Night pain in arthritis: patients at risk from prescribed night sedation.

How Pain and Analgesics Disturb Sleep

“…In rheumatic disease, 15% to 70% of patients regularly took hypnotics mainly composed by benzodiazepines. 81,82 Generally, in short-term use, benzodiazepines hasten onset of sleep, decrease nocturnal awakening, and increase total sleep time. However, they produce alterations in duration of various sleep stages.…”

Sleep Disturbance and Nonmalignant Chronic Pain: A Comprehensive Review of the Literature

“…Of particular importance is the finding that hypnotics decrease stages 1, 3, 4, and REM of sleep, while increasing stage 2 sleep [111]. Although benzodiazepines have been shown to decrease sleep latency, decrease awakenings, and increase total sleep time [111], Hardo et al [112] found that arthritic individuals who received sedative‐hypnotics at night reported significantly higher levels of pain and greater disability than those who were not receiving sedation.…”

“…Although hypnotics do promote sleep induction and maintenance, many researchers and clinicians argue that these benefits are short‐lived. In addition, benefits may be outweighed by problems such as cognitive and psychomotor impairment, possible dependence, and changes in polysomnographic changes in stage 3 and stage 4 sleep [110–112]. However, newer hypnotic agents may mitigate some of the perceived adverse effects of benzodiazepines, and clonazepam may have anti‐neuropathic analgesic effects.…”